White patches on the skin, premature graying of the scalp, eyelashes, eyebrows, and beard, and sometimes a loss of color inside the mouth these are some of the distinct signs of vitiligo. Some people might mistake it as a disease brought about by too much sun exposure. While signs of this disease commonly appear in the sun-exposed areas of the body, the cause of vitiligo is generally unknown. Doctors and researchers have formulated several theories
One would be that people develop antibodies (produced by the immune system, these are protective proteins which fight infectious agents including bacteria and viruses) which destroy melanocytes (special skin cells that produce melanin) in their own bodies; two, that melanocytes destroy themselves; and three, that a particular event, such as sunburn or emotional distress, triggers these distress—all of which have no scientific backing yet. Another theory says that is hereditary, making children whose parents are affected, prone to the disorder.
Vitiligo affects 40 to 50 million of the world’s population, including all races males and females. Majority of the people affected by vitiligo usually develop it before turning 40. Given the shady causes of vitiligo, doctors make it a point to find out about important factors in an affected person’s medical history—family history, a rash or a skin trauma two to three months before depigmentation began, stress, physical illness, and/or premature graying of the scalp. While a scientific breakthrough is yet to be done determining the cause of vitiligo, several preventive measures have been developed over the years.
Treating vitiligo would always prove to be risky. The side effects of treatments are as unpredictable as the disorder’s cause. That is why vitiligo treatment should always be done with utmost care and patience.
A person’s own tissues may be used for surgical treatment through autologous skin grafts. The doctor removes portions of the pigmented skin and then replaces the affected skin with it. Possible complications for this treatment include infections, scarring, a cobblestone appearance, or a spotty repigmentation. The greatest risk would be the skin’s failure to repigment at all.
Another surgical treatment using the pigmented skin is skin grafts using blisters. The patient’s pigmented skin is exposed to heat, which then causes blisters. These blisters are cut off and then transplanted to the depigmented area.
Another simpler option is tattooing or micropigmentation. This is usually done on patients with dark skin. Tattoos, however, tend to fade in time and may even lead to blister outbreaks.
Lastly, vitiligo can be cured surgically through autologous melanocyte transplants. Multiplying a patient’s pigmented skin through a special cell culture solution that grows melanocytes does this. The reproduced skin then is transplanted over the depigmented areas.
Additional therapies include sunscreens, which helps protect the screen from the damaging effect of the sun. Cosmetics, on the other hand, are temporary solutions, which are used to cover up the patient’s affected areas.
For a person affected by vitiligo, the first few white patches that appear on his skin can be quite tolerable. These patches usually appear in patterns. These patterns have three forms. One is the focal pattern wherein depigmentation occurs in a limited area. Second is the segmental pattern wherein patches appear only on one side of the body. Third, which is probably the worst one, is the generalized pattern wherein the depigmentation occurs in different areas of the body. Adding to this is the uncertainty of how the vitiligo will spread.
For some people, the white patches spread gradually while for some, in quick succession. Some findings say that emotional distress can cause the affected areas to increase in number. Common areas of appearance are the armpits, groin, around the mouth, eyes, nostril, navel, and genitals. A person with vitiligo may also have premature graying of the scalp hair, eyelashes, eyebrows, and beard.
There are several treatments for vitiligo patients. There are medical therapies, surgical therapies, and adjunctive therapies. Under medical therapies are topical steroid therapy, topical psoralen photochemotherapy, oral psoralen photochemotherapy, and depigmentation. Surgical therapy, on the other hand, includes skin grafts from a person’s own tissue, skin grafts using blisters, micropigmentation or tattooing, and autologous melanocyte transplants.
Coping with Vitiligo
Skin cleansers, moisturizers, toners, and facial masks—these are just some of the basic beauty maintenance products that are a part of a person’s daily regimen. It has long been accepted that the adage “Real beauty is found within,” is generally a concept that people raise their eyebrows at. While beauty is, as they say, skin-deep, physical appearance is the first thing that impacts on a person upon the first meeting.
When a person is affected by vitiligo, the change in his or her appearance can cause quite an emotional trauma. While some people attempt to appear blase, the white patches on the skin are actually quite hard to ignore especially if the person who has them is dark-skinned. The emotional trauma this causes affects the affected people in various manners depending on their age.
For adolescents, this could be the root of severe insecurity. Going to school, wherein students generally don’t have the mature capacity to be discreet or sympathetic might prove to be difficult. The stares alone could prove to be traumatic to a teenager for these are the years wherein looks are of primary concern. For adults, some might find it hard to land jobs especially ones that involve dealing with people or public relations.
There are several strategies that can be used to cope up with the emotional stress that comes with this disorder. The most important one would be finding a doctor who has inept knowledge of vitiligo and will give the patient a firm sense of security.
Medical Therapies for Vitiligo
The manifestation of vitiligo’s effects on a patient’s body is seen not only through the white patches that appear but also through the weakening of the skin’s function. The occurrence of this disorder affects the melanin content of a person’s skin, thus making him more prone to the damaging effects of the sun. The primary goal of the treating vitiligo is to improve the person’s physical appearance and restore the important functions of the skin making him less susceptible to even more skin damage.
The first option is the medical therapies. When started early, topical steroid therapy helps a great deal in repigmenting the skin meaning returning the color to those white patches that have spread around the body. Doctors advise the patients to apply corticosteroids, which are a group of drugs that resemble the hormones produced by the adrenal gland. Results usually manifest after two to three months of application, taking note this is not a therapy to cure vitiligo but a treatment that can help.
Even if it is time-consuming, psoralen photochemotherapy is proving to be one of the most beneficial treatments for vitiligo patients. It is also known as the psoralen and ultraviolet A therapy). Ultraviolet A (UVA) is a type of radiation that reaches the earth’s surface and cause the skin to tan while psoralens are drugs that contain chemicals, which react with ultraviolet light. This treatment is done by exposing the skin to UVA light from a special lamp. This must be done carefully so as to not overexpose the skin.
Patients who will undergo psoralen photochemotherapy have two options: oral which is taking psoralen by mouth, and topical which is done by applying the medicine to the skin.